The Impact of Dispensing Naloxone at Public Health Vending Machines in Clark County, Nevada

In 2017, Trac-B Exchange (a syringe services program in Clark County, Nevada), along with local constituents, launched the first-in-the-nation public health vending machine program in response to rising rates of infectious diseases among people who inject drugs. In 2020, Dr. Sean Allen collaborated with them and the Southern Nevada Health District to examine the extent to which naloxone dispensation at vending machines was associated with changes in opioid-involved overdose deaths.

In the year following naloxone dispensation at public health vending machines there were 41 fewer opioid-involved overdose fatalities than predicted.

Lessons learned throughout the public health vending machine implementation in Clark County include:

1. Machines should be located where clients can easily access them. Housing them within agencies that provide services to people who use drugs could ensure easy access.
2. Agencies interested in implementing these machines should carefully consider the costs, including the cost of buying the machines, day-to-day operational costs, supplies and packaging materials, and insurance.
3. Conducting a needs assessment with potential clients before launching the machines may help inform where they should be located and the type and volume of supplies needed at each machine.
4. Communities could increase the machines’ use and access by talking with people who use drugs about what time(s) the machines should be accessible.
5. Finally, constituents should explore community readiness and assess if trainings about harm reduction services are needed.

This work was published in the Annals of Medicine Journal in September 2022.

Since then, Dr. Allen and Dr. Melissa Walls presented to the Bois Forte Reservation Tribal Council about the public health utility of vending machine implementation. Subsequently, the Council issued a resolution (No. 101-2022) by unanimous vote authorizing the implementation of public health vending machines on reservation lands – believed to be the first tribal resolution for vending in the country.

Drs. Sean Allen and Emily Haroz also worked with Bloomberg Fellows, Erin Russell, Zach Kosinski, Callie Kaplan, Nicole Barnes and Jessica Johnson, Health Educator from the Southern Nevada Health District, on a scoping review paper about implementation considerations for harm reduction vending machines, including maximizing accessibility up to 24 hours, 7 days a week, offering syringe disposal options, ensuring capability of data collection, and allowing for anonymity of use. This paper can be found here.